Taking your own life is not a split-second decision. While we’ve heard frequently that someone can appear cheerful one morning and then go on to take their own life later that same day, the process of deciding to commit suicide is one that takes weeks, months, or years. People contemplate how to do it, and they make mental notes of why they should go through with it.
Most of the time, suicidal ideation is fed by an inner voice that ‘rationally’ guides a person through the step-by-step process of going from thinking about it, to doing it. But there’s nothing rational about suicide. While some people voluntarily choose to end their life when faced with terminal pain or a sure and painful death – usually by seeking help from a physician for voluntary euthanasia – most suicides are related to mental illness rather than terminal physical sickness.
Recognizing the warning signs of suicide is a critical skill for anyone who lives with or knows someone struggling with depression. If you believe that your friend or loved one is thinking about suicide, call the US National Suicide Prevention Lifeline at 1-800-273-8255 OR Text SIGNS to 741741. If you believe you’ve witnessed an act of attempted suicide, call your emergency services (911) immediately.
What Does Suicidal Ideation Look Like?
Suicidal ideation is the mental process of contemplating suicide. On the surface, there’s no way to truly know what someone is thinking. However, you can determine if there’s even a chance of suicidal ideation based on what someone is saying or doing.
Behavioral and verbal cues are the most obvious, and research indicates that 80% of people contemplating suicide will indicate, through jokes about death, dying or suicide, or by making reference to suicidal acts in an inappropriate manner, that they may need help. It’s common for someone to act out or say something as an indirect cry for help, and it’s important to treat any mentions of suicide seriously, especially if someone talks about killing themselves specifically. Common indicators of suicidal ideation are:
- Talking about killing yourself.
- Talking about being aimless/having no purpose/no reason to exist.
- Talking about being unbearable to be with/having no place in anyone’s life.
- Acting reckless, angry, or violent, coupled with prolonged sadness.
- Steady isolation and disappearances.
- Use of substances (from alcohol to pills).
- Actively looking into or researching ways to commit suicide.
A common misconception is that talking about suicide only makes things worse. The reality is that the stigma and taboo attached to suicide actively makes it difficult for people who need help to reach out and talk about their feelings, due to the fear of being ostracized for their thoughts and emotions.
You can goad someone into committing suicide if they’re already in a dark place to begin with, and there have been instances of suicide instigated by verbal and social bullying on an extreme level. But talking about suicide in the context of getting help, discussing ideation, and talking honestly about one’s feelings does not increase the chance of someone actually committing suicide, and is more likely to give them the hope they need to consider otherwise.
Suicidal thoughts can come and go. It’s important to understand that if you believe someone you care about or know is suicidal, and get them the help they need, their suicide risk is not automatically nullified. Depression treatment (through counseling, medication, and alternative treatments like TMS) can help someone with suicidal ideation tremendously. But their symptoms can get worse down the line, and continuous care, empathy, and support may be necessary to help them reach out and talk about their feelings if they ever resurface.
What to Do If Someone Is Suicidal
Talking about suicide with someone who has or is seriously considering taking their own life is undoubtedly scary. It’s not easy for most people to approach the subject calmly, out of fear that they may somehow be responsible for the other person’s decision. Talking someone out of a suicide attempt can also be difficult and depends entirely on where they are in their thought process, and what kind of impact your appearance and words make on them.
First things first, if you’re witnessing a potential suicide act, call emergency services and get an ambulance or the fire department (if someone is on a ledge/attempting to commit suicide by jumping). If someone is suicidal, invite them to talk to you about their problems, and discuss potentially seeking help instead. Reassure them that whatever they’re going through, things do get better. In fact, all suicidal thoughts do pass. Suicidal ideation is not rational or logical, but the result of extreme depressive thoughts, or intense and relentless emotional pain. Helping someone conceptualize a time when they won’t be feeling the way they’re feeling may give them hope that, if they hold off and agree to live just a little longer, they may be able to smile again, and dream again.
It’s important to get people help if they are contemplating suicide. Professional help through depression treatment can be critical in saving someone’s life, and in giving them the tools they need to subvert thoughts of suicide if they arise again. However, it takes more than one person to prevent a suicide.
Ways to Prevent Suicidal Ideation
Suicidal ideation has risk factors and protective factors. That means certain things cause suicidal ideation, and certain things help prevent them. For example, depression, trauma, PTSD, bullying, extreme poverty, extreme existential stress, and chronic pain can all lead to despair, hopelessness, and suicidal ideation.
However, there are also protective factors. Professional clinical care, family support, opening up conversations about suicide and tackling societal and cultural ideas that discourage suicide and treat it as a taboo/stigma to think about suicide can all help someone reconsider, and even abandon the decision to end their own life.
Don’t paint thinking about suicide to be a moral wrong or ultimate sin. Don’t stigmatize people for their self-loathing and thoughts of suicide, calling them attention-seeking. Don’t think of depression as a personal weakness and recognize that it is a medical condition. On average, 129 people kill themselves per day. Most of them don’t get the help they need and are discouraged to seek it out.